Seòmar agus comataidhean

Good morning, and welcome to the 32nd meeting in 2024 of the Public Audit Committee. The first agenda item is a decision on whether to take agenda items 3, 4 and 5 in private. Do members agree to do so?

Members indicated agreement.

The second agenda item is consideration of the Auditor General for Scotland’s section 23 report “NHS in Scotland 2024”, which is a finance and performance report. I am pleased to welcome Stephen Boyle, the Auditor General, to this morning’s meeting. He is joined by the following colleagues from Audit Scotland: Carol Calder, audit director; Leigh Johnston, senior manager; and Bernie Milligan, audit manager.

We have a wide range of questions on your wide-ranging report, Auditor General. Before we get to those questions, I invite you to make a short opening statement.

Thank you, Graham. I invite Colin Beattie to continue with some questions on the theme of financial performance.

Auditor General, I thank you for resisting the temptation, which members of the committee have put your way several times, to offer clinical judgments. I really do not think that it is fair to ask you to make those judgments.

One area that you are more comfortable and qualified to talk about is highlighted in paragraph 100 of today’s report. That is a recent report by the chief medical officer that talks about the need to focus on

“equity, prevention and early intervention”.

I recall that, in the report, “Fiscal sustainability and reform in Scotland”, on which we considered evidence last week, you once again used, as a touchstone, the Christie report, which you said had “remarkable longevity” and “ongoing relevance”. Those themes are captured in the chief medical officer’s assessment, too.

We have spoken a lot this morning about reforms to the NHS, but there is a wider palette of reform—perhaps social and even economic—that we might need to look at if we are to see a shift in the provision of health services and how we best improve public health in Scotland.

A couple of weeks ago, the committee took evidence on digital exclusion, which you produced a report on several months ago. I would have thought that, if a public body had been asked by the Scottish Government three times to give evidence of the action that it was taking to implement public service reform, it would have at least looked at digitalisation or a change in the way that services are delivered, whether we agree with that or not. I would have thought that that would be an obvious go-to place for lots of the public bodies that were asked for information about what they were doing to reform the services that they provide.

Thanks. That would be helpful.

Great. I will turn to what you have said about progress on public service reform. There is a certain clarity in what you have said about that in the section 23 report. You are fairly blunt after paragraph 68 in saying:

“The Scottish Government does not know what savings will result from reform, or what reform efforts will cost”.

You also say that

“The Scottish Government’s governance arrangements for reform were ineffective and have recently changed”

and that

“The Scottish Government is not providing effective leadership on reform”.

In paragraph 87, you say that

“the impact on outcomes is not currently considered or monitored as part of the reform process”,

so it is not considered at all and neither is it monitored.

Those are fairly fundamental criticisms of the Scottish Government’s approach to public service reform, are they not?

You highlight a familiar theme for the Public Audit Committee and in your reports: what is, to all intents and purposes, an implementation gap. There is a stated Government ambition, but delivery on the ground does not match up with that. That is the summation of what you are saying in the report, is it not?

Thank you very much. That brings to an end this evidence session. Thank you, Auditor General, for your time and input. I also thank Carole Grant, Fiona Diggle and Richard Robinson for their contributions. It has been greatly appreciated and you have set a useful platform for us upon which we may stand and ask some questions of the Scottish Government. Again, thank you very much indeed for your evidence.

I move the meeting into private session.

Forgive me, these are matters that we will probably raise with the Scottish Government, but to help us to understand what the answer might be, we have some questions that we are putting to you.